Effectiveness of stress arousal reappraisal and stress-is-enhancing mindset interventions on task performance outcomes: a meta-analysis of randomized controlled trials

Stress arousal reappraisal (SAR) and stress-is-enhancing (SIE) mindset interventions aim to promote a more adaptive stress response by educating individuals about the functionality of stress. As part of this framework, an adaptive stress response is coupled with improved performance on stressful tasks. The goal of this meta-analysis is to evaluate the effectiveness of these interventions on task performance. The literature search yielded 44 effect sizes, and a random-effects model with Knapp-Hartung adjustment was used to pool them. The results revealed an overall small significant improvement in task performance (d = 0.23, p < 0.001). The effect size was significantly larger for mixed interventions (i.e., SAR/SIE mindset instructions combined with additional content, k = 5, d = 0.45, p = 0.004) than SAR-only interventions (k = 33, d = 0.22, p < 0.001) and SIE mindset-only interventions (k = 6, d = 0.18, p = 0.22) and tended to be larger for public performance tasks than cognitive written tasks (k = 14, d = 0.34, p < 0.001 vs. k = 30, d = 0.20, p = 0.002). Although SAR and SIE mindset interventions are not “silver bullets”, they offer a promising cost-effective low-threshold approach to improve performance across various domains.


Information sources
6 Specify all databases, registers, websites, organisations, reference lists and other sources searched or consulted to identify studies.Specify the date when each source was last searched or consulted.
Pages 9-10 Search strategy 7 Present the full search strategies for all databases, registers and websites, including any filters and limits used.Supplementary Table S2 Selection process 8 Specify the methods used to decide whether a study met the inclusion criteria of the review, including how many reviewers screened each record and each report retrieved, whether they worked independently, and if applicable, details of automation tools used in the process.
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Data collection process
9 Specify the methods used to collect data from reports, including how many reviewers collected data from each report, whether they worked independently, any processes for obtaining or confirming data from study investigators, and if applicable, details of automation tools used in the process.
Pages 10-11 Data items 10a List and define all outcomes for which data were sought.Specify whether all results that were compatible with each outcome domain in each study were sought (e.g. for all measures, time points, analyses), and if not, the methods used to decide which results to collect.
Pages 10-13 10b List and define all other variables for which data were sought (e.g.participant and intervention characteristics, funding sources).Describe any assumptions made about any missing or unclear information.
Pages 10-13 Study risk of bias assessment 11 Specify the methods used to assess risk of bias in the included studies, including details of the tool(s) used, how many reviewers assessed each study and whether they worked independently, and if applicable, details of automation tools used in the process.

Supplementary
Table S3 and Note Effect measures 12 Specify for each outcome the effect measure(s) (e.g.risk ratio, mean difference) used in the synthesis or presentation of results.Page 11

Synthesis methods
13a Describe the processes used to decide which studies were eligible for each synthesis (e.g.tabulating the study intervention characteristics and comparing against the planned groups for each synthesis (item #5)).
Pages 11-13 13b Describe any methods required to prepare the data for presentation or synthesis, such as handling of missing summary statistics, or data conversions.
Pages 11-13 13c Describe any methods used to tabulate or visually display results of individual studies and syntheses.Pages 11

# Checklist item
Location where item is reported 13d Describe any methods used to synthesize results and provide a rationale for the choice(s).If meta-analysis was performed, describe the model(s), method(s) to identify the presence and extent of statistical heterogeneity, and software package(s) used.
Page 11 13e Describe any methods used to explore possible causes of heterogeneity among study results (e.g.subgroup analysis, meta-regression).
Pages 13-14 13f Describe any sensitivity analyses conducted to assess robustness of the synthesized results.-

Reporting bias assessment
14 Describe any methods used to assess risk of bias due to missing results in a synthesis (arising from reporting biases).Page 13 Certainty assessment 15 Describe any methods used to assess certainty (or confidence) in the body of evidence for an outcome.13

Study selection 16a
Describe the results of the search and selection process, from the number of records identified in the search to the number of studies included in the review, ideally using a flow diagram.

15
16b Cite studies that might appear to meet the inclusion criteria, but which were excluded, and explain why they were excluded.15

Study characteristics
17 Cite each included study and present its characteristics.Table 1 Risk of bias in studies 18 Present assessments of risk of bias for each included study.
Table 1, Supplementary Table S3 Results of individual studies 19 For all outcomes, present, for each study: (a) summary statistics for each group (where appropriate) and (b) an effect estimate and its precision (e.g.confidence/credible interval), ideally using structured tables or plots.
Figure 2 Results of syntheses 20a For each synthesis, briefly summarise the characteristics and risk of bias among contributing studies.Pages 15-16 20b Present results of all statistical syntheses conducted.If meta-analysis was done, present for each the summary estimate and its precision (e.g.confidence/credible interval) and measures of statistical heterogeneity.If comparing groups, describe the direction of the effect.27 Report which of the following are publicly available and where they can be found: template data collection forms; data extracted from included studies; data used for all analyses; analytic code; any other materials used in the review.S2.Search Strings.